Prevalence Estimates Research Articles

Gestational Diabetes Prevalence Estimates from Three Data Sources, 2018.

We investigated 2018 gestational diabetes mellitus (GDM) prevalence estimates in three surveillance systems (National Vital Statistics System, State Inpatient Database, and Pregnancy Risk Assessment Monitoring Survey). We calculated GDM prevalence for jurisdictions represented in each system; a subset of data was analyzed for people 18-39 years old in 22 jurisdictions present in all three systems to observe dataset-specific demographics and GDM prevalence using comparable categories. GDM prevalence estimates varied widely by data system and within the data subset despite comparable demographics. Understanding the differences between GDM surveillance data systems can help researchers better identify people and places at higher risk of GDM.

Prevalence of HCV infection in Europe in the DAA era: Review.

In 2016, the Global Health Sector Strategy, ratified by the 69th World Health Assembly, set the ambitious goal of eliminating hepatitis C virus (HCV) and hepatitis B virus infections by 2030, emphasizing the importance of national screening programmes. Achieving this goal depends on each country's ability to identify and treat 80% of chronic hepatitis C cases, a critical threshold set by the World Health Organization. Traditionally, estimates of HCV prevalence have been based on interferon era studies that focused on high-risk subgroups rather than the general population. In addition, the incomplete data available from national registries also limited the understanding of HCV prevalence. The 2016 report from the European Centre for Disease Prevention and Control highlighted that HCV rates varied across European counties, ranging from .1% to 5.9%. However, data were only available for 13 countries, making the overall picture less clear. Additionally, the epidemiological data may have underestimated the true burden of HCV due to lack of awareness among those with chronic infection. The main objective of this review is to provide a comprehensive summary of HCV epidemiology in Europe in the current era of direct-acting antivirals (DAAs). The data included in the analysis range from the end of 2013 to December 2023 and have been categorised according to the United Nations Geoscheme. The resulting synthesis underscores the noteworthy impact of DAA treatment on the epidemiological situation.

Socioeconomic inequalities in pandemic-induced psychosocial stress in different life domains among the working-age population

BackgroundPsychosocial stress is considered a risk factor for physical and mental ill-health. Evidence on socioeconomic inequalities with regard to the psychosocial consequences of the COVID-19 pandemic in Germany is still limited. We aimed to investigate how pandemic-induced psychosocial stress (PIPS) in different life domains differed between socioeconomic groups.MethodsData came from the German Corona-Monitoring nationwide study – wave 2 (RKI-SOEP-2, November 2021–February 2022). PIPS was assessed using 4-point Likert scales with reference to the following life domains: family, partnership, own financial situation, psychological well-being, leisure activity, social life and work/school situation. Responses were dichotomised into “not stressed/slightly stressed/rather stressed” (0) versus “highly stressed” (1). The sample was restricted to the working-age population in Germany (age = 18–67 years, n = 8,402). Prevalence estimates of high PIPS were calculated by sex, age, education and income. Adjusted prevalence ratios (PRs) were estimated using Poisson regression to investigate the association between education/income and PIPS; high education and income were the reference groups.ResultsThe highest stress levels were reported in the domains social life and leisure activity. Women and younger participants reported high stress levels more frequently. The highest inequalities were found regarding people’s own financial situation, and PIPS was higher in low vs. high income groups (PR 5.54, 95% CI 3.61–8.52). Inequalities were also found regarding partnerships with higher PIPS in low vs. high education groups (PR 1.68, 95% CI 1.13–2.49) – and psychological well-being with higher PIPS in low vs. high income groups (PR 1.52, 95% CI 1.14–2.04).ConclusionSocioeconomic inequalities in PIPS were found for different life domains. Generally, psychosocial support and preventive interventions to help people cope with stress in a pandemic context should be target-group-specific, addressing the particular needs and circumstances of certain socioeconomic groups.

Prevalence of PTSD in Active Duty Members with Mild Traumatic Brain Injury: Systematic Review and Meta-analysis.

Traumatic brain injury (TBI), particularly mild TBI (mTBI), is a significant health concern for U.S. active duty service members (ADSMs), with potential implications for psychiatric outcomes including PTSD. Despite recognizing this association, the prevalence of PTSD among ADSMs with mTBI remains unclear. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A thorough search in PubMed, CINAHL, Embase, and PsycINFO databases from 2008 to 2024 focused on identifying studies involving ADSMs with PTSD and mTBI. The R software (version 4.3.2) was employed for meta-analysis with the "meta" and "meta prop" packages. Eight reviewed studies revealed a pooled prevalence estimate of PTSD among ADSMs with mTBI at 36% (95% CI, 30%-41%, P < .01, I2 = 96%). Cohort studies indicated a slightly higher prevalence of 38% (95% CI, 19%-59%, P < .01, I2 = 98%), whereas cross-sectional studies provided a marginally lower prevalence of 34% (95% CI, 27%-40%, P < .01, I2 = 92%). Methodological differences, including diagnostic criteria variability, contribute to the observed variability in prevalence estimates. Despite methodological challenges, this study provides crucial insights into the pooled prevalence of comorbid PTSD and mTBI within the military, emphasizing the need for standardized methodologies and further research to refine understanding and support strategies for affected individuals.

A Computationally Efficient Approach to Fully Bayesian Benchmarking

In small area estimation, it is sometimes necessary to use model-based methods to produce estimates in areas with little or no data. In official statistics, we often require that aggregates of small area estimates agree with national estimates for internal consistency purposes. Enforcing this agreement is referred to as benchmarking, and while methods currently exist to perform benchmarking, few are ideal for applications with non-normal outcomes and benchmarks with uncertainty. Fully Bayesian benchmarking is a theoretically appealing approach insofar as we can obtain posterior distributions conditional on a benchmarking constraint. However, existing implementations may be computationally prohibitive. In this paper, we critically review benchmarking methods in the context of small area estimation in low- and middle-income countries with binary outcomes and uncertain benchmarks, and propose a novel approach in which posterior samples of small area characteristics from an unbenchmarked model can be combined with a rejection sampler or Metropolis-Hastings algorithm to produce benchmarked posterior distributions in a computationally efficient way. To illustrate the flexibility and efficiency of our approach, we provide comparisons to an existing benchmarking approach in a simulation, and applications to HIV prevalence and under-5 mortality estimation. Code implementing our methodology is available in the R package stbench.

Rates of bronchopulmonary dysplasia in very low birth weight neonates: a systematic review and meta-analysis

ImportanceLarge-scale estimates of bronchopulmonary dysplasia (BPD) are warranted for adequate prevention and treatment. However, systematic approaches to ascertain rates of BPD are lacking.ObjectiveTo conduct a systematic review and meta-analysis to assess the prevalence of BPD in very low birth weight (≤ 1,500 g) or very low gestational age (< 32 weeks) neonates.Data sourcesA search of MEDLINE from January 1990 until September 2019 using search terms related to BPD and prevalence was performed.Study selectionRandomized controlled trials and observational studies evaluating rates of BPD in very low birth weight or very low gestational age infants were eligible. Included studies defined BPD as positive pressure ventilation or oxygen requirement at 28 days (BPD28) or at 36 weeks postmenstrual age (BPD36).Data extraction and synthesisTwo reviewers independently conducted all stages of the review. Random-effects meta-analysis was used to calculate the pooled prevalence. Subgroup analyses included gestational age group, birth weight group, setting, study period, continent, and gross domestic product. Sensitivity analyses were performed to reduce study heterogeneity.Main outcomes and measuresPrevalence of BPD defined as BPD28, BPD36, and by subgroups.ResultsA total of 105 articles or databases and 780,936 patients were included in this review. The pooled prevalence was 35% (95% CI, 28-42%) for BPD28 (n = 26 datasets, 132,247 neonates), and 21% (95% CI, 19-24%) for BPD36 (n = 70 studies, 672,769 neonates). In subgroup meta-analyses, birth weight category, gestational age category, and continent were strong drivers of the pooled prevalence of BPD.Conclusions and relevanceThis study provides a global estimation of BPD prevalence in very low birth weight/low gestation neonates.

Asymptomatic infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis among women in low- and middle-income countries: A systematic review and meta-analysis.

Syndromic management of sexually transmitted infections (STIs) is common in settings with limited access to diagnostic testing. However, this approach does not capture asymptomatic STIs. Untreated asymptomatic infections may result in serious complications and sequelae in women. We aimed to estimate the proportion and the prevalence of asymptomatic Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infections among women in low- and middle-income countries. We searched Medline, Scopus, and Web of Science for articles published between 2000 and 2022. We used random effect models to compute the proportion and prevalence estimates and performed sub-group analysis. We evaluated the quality of each article using the Appraisal tool for Cross-Sectional Studies and performed sensitivity analyses. This study was registered with PROSPERO, CRD42022286673. Forty-eight eligible studies were included. The proportion of asymptomatic CT, NG, and TV infections were: 60.7% [95% Confidence Interval (CI): 50.4; 70.5], 53.3% [37.1; 69.1], and 56.9% [44.6; 68.9], respectively. The proportion of women with asymptomatic infections was the highest in Africa for the three pathogens. The pooled prevalence of asymptomatic CT, NG, and TV infection was 4.70 per 100 women [95%CI: 3.39; 6.20], 3.11 [1.34; 5.54], and 5.98 [3.46; 9.12], respectively. More than half of the women infected by CT, NG, or TV were asymptomatic. To avoid undiagnosed and untreated asymptomatic infections leading to complications, alternative approaches to syndromic management urgently need to be considered.

Incidence and prevalence of eating disorders among U.S. military service members, 2016-2021.

Despite unique experiences that may increase eating disorder risk, U.S. military service members are an understudied population. The current study examined incidence and prevalence of eating disorder diagnoses in U.S. military personnel. This retrospective cohort study utilized Military Health System Data Repository (MDR) data on eating disorder diagnoses (2016-2021). Active duty, Reserve, and National Guard U.S. military service members who received care via TRICARE Prime insurance were identified by ICD-10 eating disorder diagnostic codes. During the 6-year surveillance period, 5189 Service members received incident eating disorders diagnoses, with a crude overall incidence rate of 6.2 cases per 10,000 person-years. The most common diagnosis was other/unspecified specified eating disorders, followed by binge-eating disorder, bulimia nervosa, and anorexia nervosa. There was an 18.5% overall rise in total incident cases across the surveillance period, but this trend was not statistically significant (p = 0.09). Point prevalence significantly increased across the 6-year timeframe for total eating disorders (p < 0.001). Period prevalence for 6-year surveillance period was 0.244% for total eating disorders, 0.149% for other/unspecified eating disorder, 0.043% for bulimia nervosa, 0.038% for binge-eating disorder, and 0.013% for anorexia nervosa. Overall crude incidence estimates for total eating disorders were higher than reported in prior research that included only active duty Service members and required an eating disorder diagnosis code in the first or second diagnostic position of the medical record. Comprehensive and confidential studies are needed to more thoroughly characterize the nature and scope of eating disorder symptomatology within U.S. military personnel. U.S. military service members are a vulnerable population with regard to eating disorder symptoms. Previously reported incidence and prevalence estimates using data from the Military Health System may have been underestimated due to overly stringent case definitions. Given personal and occupational barriers (e.g., career consequences), confidential studies of military personnel may provide more complete data on the scope of eating disorders to inform screening and clinical practice guidelines for military populations.

#1252 Non-standardized definition of chronic dialysis within German health claims data results in varying estimates for incidence and mortality

Abstract Background and Aims Chronic dependency on dialysis in patients with chronic kidney failure (CKF) demands invasive, high-risk, and costly treatments. At present, there is no standardized definition for dialysis-dependent CKF within German health claims data from statutory health insurance (SHI) funds. Method Random samples from four year tranches (2012, 2014, 2016, 2018), each with 62,200 individuals aged ≥70 years, of German health claims data of the SHI AOK Nordost were analysed. Four literature-based definitions of dialysis-dependent CKF (1–4) and a newly developed definition, based on a billing logic with criteria required for monetary reimbursement for chronic dialysis treatments in patients with CKF by SHIs, were selected. The definitions were compared with regard to sociodemographic and clinical characteristics, dialysis-dependent CKF prevalence and incidence (standardized by year-, age group-, and sex-specific weights for Northeast-Germany), overall mortality, and direct health care costs. Results All definitions of dialysis-dependent CKF resulted in varying estimates of 12-month prevalence (0.33–0.61%) and six-month incidence (0.058–0.100%). Depending on the definition, 27.6% to 61.8% of incident individuals had a preceding acute kidney injury (AKI). Survival probabilities of individuals with dialysis-dependent CKF ranged from 70.2% to 88.1% and 60.5 to 81.3% after three and six months, respectively (Fig. 1). After stratification, survival probabilities differed less between the definitions in individuals without a preceding AKI. Monthly health care cost ranged from 6,010 to 9,606 EUR and varied strongly in out- and inpatient treatment costs depending on the definition. Cost was highest in inpatients with preceding AKI. Conclusion Due to a non-standardized definition of dialysis-dependent CKF in claims data we found varying case numbers, mortality, and health care costs, most probably in large part explained by the discrepant inclusion of individuals with short-term dialysis treatment due to AKI.

#2449 Prevalence and determinants of chronic kidney disease among older community-dwelling adults in Ireland

Abstract Background and Aims Chronic Kidney Disease (CKD) is a major global health challenge with substantial morbidity and mortality. In Ireland, a comprehensive understanding of the determinants of CKD is lacking, with limited data on the combined impact of socioeconomic and traditional risk factors. While the Irish Longitudinal Study on Ageing (TILDA) has offered insights into CKD burden, a detailed examination of its determinants remains unexplored. The goal of this study was to explore the prevalence and determinants of CKD at the community level within the Irish population. Method This is a retrospective cohort study that utilised cross sectional data from the first wave of TILDA conducted between 2009 and 2011. Participants aged 50 years and older who had health assessment and kidney function tests performed were included. The 2012 and 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations were employed to calculate estimated glomerular filtration rates (eGFR) based on cystatin C and creatinine levels. CKD was classified as eGFR &amp;lt; 60 ml/min/1.73 m². We determined the weighted prevalence of CKD using sample weights. Stepwise multivariable logistic regression models were used to identify correlates of CKD and models’ performance were assessed using AUC-ROC curves and the Akaike Information Criterion (AIC). Associations were expressed using adjusted odds ratios (AOR) with 95% confidence intervals (CIs). Results Among the 5 386 participants tested for cystatin C and serum creatinine, the weighted CKD prevalence was 11.3% based on the 2021 CKD-EPI definition (excluding race) and 13.9% using the 2012 definition. Prevalence was significantly higher in women than men, and increased with age, reaching about 45% in women over 71 years versus 29% in men. Burden of comorbid conditions in CKD individuals varied from 11% (for cancer) to 89% (for hypertension) and were significantly higher than non-CKD individuals (P&amp;lt; 0.001). Adjusting for age, sex, education, and employment, the adjusted odds of CKD were significantly higher for individuals with hypertension AOR 2.15 (95% CI: 1.58–2.96), diabetes AOR 2.00 (95% CI: 1.50–2.66), cardiovascular disease AOR 1.72 (95% CI: 1.43–2.21), cancer AOR 1.64 (95% CI: 1.16–2.30), and obesity AOR 2.18 (95% CI: 1.61–2.96). The likelihood of CKD was also higher for patients with a hospital admission in the previous year AOR = 1.50 (95% CI: 1.14–1.96), possession of a medical card AOR 1.41 (95% CI: 1.06–1.89), and unemployed individuals AOR 1.61, (95% CI: 1.06–2.50), while the likelihood was significantly lower for individuals with a tertiary education (versus primary) AOR 0.73 (95% CI: 0.54–0.98). With further adjustment for medications, the magnitude of these associations was greatly attenuated with increasing odds of CKD for those receiving higher medication burden: 2-3 drugs AOR 2.02, (95% CI: 1.29–3.29), 3-4 drugs AOR 2.52 (95% CI: 1. 59–4.11), and &amp;gt; 5 drugs AOR 4.49 (95% CI: 2.81–7.39) (see Fig. 1). The AUC score ranged from 0.84 to 0.88, indicating strong model performance. Conclusion This study brings renewed attention to observed variation in national estimates of CKD prevalence (11.3% vs 13.9%) that are derived from current prediction equations with important implications for the strategic planning and resourcing of CKD care. This study emphasises the impact of socioeconomic factors, such as health coverage and financial barriers to heath care, education attainment, and employment, on CKD beyond traditional risk factors. Furthermore, the attenuation of known risk factors with increasing medication use highlights the influence of these treatments on CKD dynamics. These findings provide valuable insights for targeted public health strategies and awareness programs in Irish communities to address the increasing burden of CKD.

#826 Protein-energy wasting and sarcopenia in assessing the outcomes and quality of dialysis

Abstract Background and Aims Sarcopenia is one of the serious complications of long-term hemodialysis (HD) therapy and is one of the independent predictors of morbidity and mortality in this population. Sarcopenia is associated with low physical activity, depression and low social adaptation. There are few estimates of the sarcopenia prevalence in HD patients, and they fit into the range of 15-30% in the general group and 45-60% among patients over 60 yo. The aim: in a prospective study, to clarify the prevalence, outcomes and risk factors of sarcopenia in comparison with protein and energy wasting (PEW) severity data. The results of the first year follow-up of the first cohort in the ongoing study are presented below. Method In the group of 99 prevalent patients of single HD center (vintage 26.4; 21.8-93.3 months; age 55±17 years, HD/HDF for 4-4.5 hours three-time weekly; Kt/V 1.57±0.31), the prevalence of sarcopenia was estimated (muscle mass was assessed anthropometrically and by bioimpedance (BIA), BodyStat 5000). The presence of sarcopenia was assessed by EWGSOP2 criteria, muscle strength - by wrist expander. The reference values for men and women were &amp;gt;27 kg and &amp;gt;16 kg. The PEW degree was assessed by 24-point scale (BMI, arm circumference, skin-fat fold above the triceps, arm muscle circumference, total protein, albumin, transferrin, absolute lymphocytosis; max 3 point for each). Obesity was established at BMI &amp;gt;30 kg/m² or according to the fat mass index &amp;gt;9 kg/m² in men and &amp;gt;13 kg/m² in women. The quality of life was assessed by KDQOL-SF™ after exclusion of patients with significant depression by the Beck scale. Results The muscle mass indices calculated anthropometrically (IMMA) and by bioimpedance (IMMB) were well correlated: IMMA=0.15+1.06×IMMB, R²=76%; diagnostic efficacy (in detecting sarcopenia) IMMA to IMMB was 86%. The prevalence of PEW by stage: absent (scores of all assessed scales - 3) – 59%, grade 1 (average score ≥2 and &amp;lt;3) – 32%, grade 2 (average score ≥1 and &amp;lt;2); in one patient, PEW was classified as severe (average score of scales &amp;lt;1). In the univariate and in the multiple adjusted analysis (for age, gender, provided dialysis dose and average ultrafiltration, hemoglobin and phosphate levels), the degree of PEW or the presence of PEW was not associated with the risk of death. At the same time, the phase angle (PA) of bioimpedance had such a link: the PA increase in by 1° was associated with a 24.4% reduction in the risk of death (95%CI 3.9-40.4%; p=0.022), and the inclusion of the same set of variables in the regression analysis model as for the PEW only weakened, but did not eliminated the link (OR decrease by 26.9%; 0.3-46.4%; p=0.048). The risk of death was not associated with obesity. Sarcopenia was detected in 52% of patients. It was not associated with the presence (severity) of PEW in women, but in men it was 1.48 times more common in the presence of PEW (p=0.049); in the entire group, the higher prevalence of sarcopenia in the presence of PEW (by 34%) did not reach significance (p=0.3). In multiple regression analysis, the presence of sarcopenia was associated with a 1.95-fold higher risk of death (95% CI 1.001-3.809; p=0.050). In the presence of sarcopenia, the quality of life scores were significantly lower for the scales of Physical functioning, Energy, and Physical Composite Score. The higher prevalence of sarcopenia among men than in women remains unexplained. It is possible that uniform thresholds for muscle mass and muscle strength are not suitable for all populations and require clarification. Conclusion Sarcopenia is the feature of more than half of HD patients and is significantly associated with an increased risk of death. PEW and sarcopenia, including partially similar indicators in their estimates, turned out to be poorly related in HD patients, and sarcopenia is more closely associated with hard outcomes than PEW. A separate assessment of these conditions and a search for contributing factors for its development/progression are required in prospective studies. One of the key objectifying indicators of the PEW and sarcopenia assessment could be the phase angle of bioimpedance associated with both clinical predictors and outcomes.

Prevalence, phenomenology, and impact of misophonia in a nationally representative sample of U.S. adults.

Misophonia is characterized by decreased tolerance for and negative reactions to certain sounds and associated stimuli, which contribute to impairment and distress. Research has found that misophonia is common in clinical, college, and online samples; yet, fewer studies have examined rates of misophonia in population-based samples. The current study addresses limitations of prior research by investigating misophonia prevalence, phenomenology, and impairment in a large, nationally representative sample of adults in the United States. Probability-based sampling was used to administer a survey to a representative sample of U.S. households. Data were adjusted with poststratification weights to account for potential sampling biases and examined as weighted proportions to estimate the outcomes. The sample included 4,005 participants (51.5% female; 62.5% White). Sensitivity to misophonia sounds was reported by 78.5% of the sample, and 4.6% reported clinical levels of misophonia. Results demonstrated significant demographic differences in misophonia symptom severity. Specifically, significantly higher misophonia symptoms were observed for participants who identified as female, less than 55 years old, less than a high school education, never married, lower income, and those working part time, compared to each of the respective comparison groups. Those with clinically significant misophonia symptoms reported that symptoms often onset in childhood and adolescence, were persistent, and contributed to severe impairment in at least one life domain. These findings provide a prevalence estimate of misophonia in the general population of the United States and inform our understanding of who is affected by misophonia. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

#305 Global health inequalities of CKD: a systematic review and meta-analysis examining prevalence and disparities in age, sex and socio-economic status

Abstract Background and Aims Chronic kidney disease (CKD) is a significant contributor to global morbidity and mortality. Age, sex and socio-economic status are considered to be influential in the development, progression and outcomes from CKD. This study investigated disparities in age, sex and socio-economic status in CKD and updated global prevalence estimates through systematic review and meta-analysis. Method Five databases (MEDLINE/PubMed, Embase, Cochrane CENTRAL Library, CINAHL, Web of Science) were searched from 2014 to 2022, with 14,871 articles screened, 119 papers included and data analysed on 29,159,948 participants. Studies were included if they described CKD prevalence in participants over the age of 18 and were carried out in the general population. CKD was defined on the basis of albuminuria/proteinuria and/or an estimated glomerular filtration rate of &amp;lt;60 ml/min/m2. Random effects meta-analyses using generalised linear mixed models were conducted to determine overall prevalence, prevalence of stages 3–5 and prevalence in males and females. Influences of age, sex and socio-economic status were assessed in subgroup analyses, and risk of bias assessment and meta-regressions were conducted to explore heterogeneity. Results Overall prevalence of CKD was 13.0% (11.3–14.8%) and 6.6% (5.6–7.8%) for stages 3–5. Prevalence was higher in studies where all participants were over the age of 60 (19.3% for stages 1–5. 15.0% for stages 3–5) and meta-regression demonstrated association of age, body mass index, diabetes and hypertension with prevalence of CKD stages 3–5. The prevalence of CKD stages 1–5 was similar in males and females (13.1% versus 13.2%) but prevalence of stages 3–5 was higher in females (6.4% versus 7.5%). Overall prevalence was 11.4%, 15.0% and 10.8% in low, middle and high-income countries respectively; for stages 3–5 prevalence was 4.0%, 6.7% and 6.8%, respectively. Risk of bias of included studies was generally moderate or high, with 8% at low risk of bias, 44% at moderate risk of bias and 48% at high risk of bias. Conclusion With nearly 30 million participants, this study is the largest systematic review on CKD prevalence to date, with prevalence demonstrated to be persistently high globally. It has highlighted that important disparities related to age, sex and socio-economic status may exist, and addressing these concerns should be a priority for policymakers. Future research should focus on targeted screening and treatment approaches, improving access to care and more effective data monitoring, particularly in low and middle income countries.

Trends in chlamydia prevalence in the United States, 2005–2016

In the United States (US), chlamydia is the most frequently reported sexually transmitted infection that is nationally notifiable. We examined trends in chlamydia prevalence in the US in 2011–2016 compared with 2005–2010. Cross-sectional, nationally representative surveys, National Health and Nutrition Examination Surveys (NHANES), were used to compare national chlamydia prevalence estimates from 2011 to 2016 with those from 2005 to 2010, and changes in prevalence since 1999–2004 were also reviewed. Persons aged 18–39 years were included in these analyses. Prevalence of chlamydia was based on results from urine specimens. Results were weighted to represent the U.S. civilian, noninstitutionalized population. The baseline characteristics of the study population were similar in gender, age and race/ethnicity between the two groups (P > 0.05). The overall chlamydia prevalence was 1.88% (95% confidence interval [CI] 1.55–2.22%) in 2011–2016 and 1.57% (95% CI 1.27–1.87%) in 2005–2010, a relative increase of 19.7% (95% CI 0.2–39.2%; P < 0.05) between the two surveys. Increases in chlamydia prevalence was especially concentrated in persons who were male, aged 18 to 29 years, had > high school educational level, never married, age at first sex < 18 years, had 2–5 sexual partners in lifetime and had no past sexually transmitted diagnosis between 2005 and 2016 (P < 0.05). Multivariable logistic regression analysis demonstrated that chlamydia was more prevalent in those aged 18–29 years, being non-Hispanic Blacks, had high school educational level, being widowed/divorced/separated and had > 5 sexual partners. The chlamydia prevalence had an increasing trend from 2005–2010 to 2011–2016. Those with high chlamydia prevalence such as sexually active young adults and Non-Hispanic Black should be screened annually so that infected persons can be diagnosed and they and their sex partners can be treated promptly.

Prevalence of Mild Cognitive Impairment and Alzheimer's Disease Identified in Veterans in the United States.

Diagnostic codes can be instrumental for case identification in Alzheimer's disease (AD) research; however, this method has known limitations and cannot distinguish between disease stages. Clinical notes may offer more detailed information including AD severity and can complement diagnostic codes for case identification. To estimate prevalence of mild cognitive impairment (MCI) and AD using diagnostics codes and clinical notes available in the electronic healthcare record (EHR). This was a retrospective study in the Veterans Affairs Healthcare System (VAHS). Health records from Veterans aged 65 years or older were reviewed during Fiscal Years (FY) 2010-2019. Overall, 274,736 and 469,569 Veterans were identified based on a rule-based algorithm as having at least one clinical note for MCI and AD, respectively; 201,211 and 149,779 Veterans had a diagnostic code for MCI and AD, respectively. During FY 2011-2018, likely MCI or AD diagnosis was defined by≥2 qualifiers (i.e., notes and/or codes)≥30 days apart. Veterans with only 1 qualifier were considered as suspected MCI/AD. Over the 8-year study, 147,106 and 207,225 Veterans had likely MCI and AD, respectively. From 2011 to 2018, yearly MCI prevalence increased from 0.9% to 2.2%; yearly AD prevalence slightly decreased from 2.4% to 2.1%; mild AD changed from 22.9% to 26.8%, moderate AD changed from 26.5% to 29.1%, and severe AD changed from 24.6% to 30.7. The relative distribution of AD severities was stable over time. Accurate prevalence estimation is critical for healthcare resource allocation and facilitating patients receiving innovative medicines.

Urban-Rural Differences in the Prevalence of Diabetes Among Adults in Haryana, India: The ICMR-INDIAB Study (ICMR-INDIAB-18).

Diabetes is a multifactorial disease with far-reaching consequences. Environmental factors, such as urban or rural residence, influence its prevalence and associated comorbidities. Haryana-a north Indian state-has undergone rapid urbanisation, and part of it is included in the National Capital Region (NCR). The primary aim of the study is to estimate the prevalence of diabetes in Haryana with urban-rural, NCR and non-NCR regional stratification and assess the factors affecting the likelihood of having diabetes among adults. This sub-group analysis of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study (a nationally representative cross-sectional population-based survey) was done for Haryana using data from 3722 participants. The dependent variable was diabetes, while residence in NCR/non-NCR and urban-rural areas were prime independent variables. Weighted prevalence was estimated using state-specific sampling weights and standardized using National Family Health Survey-5 (NFHS-5) study weights. Associations were depicted using bivariate analysis, and factors describing the likelihood of living with diabetes were explored using a multivariable binary logistic regression analysis approach. Overall, the weighted prevalence of diabetes in Haryana was higher than the national average (12.4% vs. 11.4%). The prevalence was higher in urban (17.9%) than in rural areas (9.5%). The prevalence of diabetes in rural areas was higher in the NCR region, while that of prediabetes was higher in rural non-NCR region. Urban-rural participants' anthropometric measurements and biochemical profiles depicted non-significant differences. Urban-rural status, age and physical activity levels were the most significant factors that affected the likelihood of living with diabetes. The current analysis provides robust prevalence estimates highlighting the urban-rural disparities. Urban areas continue to have a high prevalence of diabetes and prediabetes; rural areas depict a much higher prevalence of prediabetes than diabetes. With the economic transition rapidly bridging the gap between urban and rural populations, health policymakers should plan efficient strategies to tackle the diabetes epidemic.

Prevalence estimation of sarcopenia using bioelectrical impedance analysis in elderly people in Lahore

Sarcopenia is the loss of muscle mass and strength, or both, and physiological functions through aging. Early detection of muscle weakness results in better care and interventions regarding dietary habits and protein intake in older adults. The objective of this study was to investigate the prevalence of sarcopenia in a Pakistani population and to correlate dietary habits and lifestyle with the prevalence of sarcopenia. A sample size of 150 individuals, both male and female, of age sixty and above was used. Cardiovascular disease and renal failure patients were excluded. The research field was the community of Lahore. Muscle power was calculated using a handgrip strength dynamometer, and gait speed was calculated using a pedometer. After screening, muscle mass was calculated using bioelectrical impedance analysis, from which sarcopenia was diagnosed. In the age group of 60–65 years, 123 individuals (82%) had low muscle strength and 93 (83%) had low muscle mass. In the age group of 66–70 years, 15 individuals (83.3%) had low muscle strength. In the age group of 71–75 years, 9 individuals (90%) had low muscle strength. The percentage of low muscle strength in the age group of 76+ years was 100%. The percentage of severe sarcopenia was 6%, and moderate sarcopenia was approximately 10% for individuals 60 years of age and older. The prevalence rates of sarcopenia were 21.53% in males and 11.76% in females. Sarcopenia is an emerging health issue in older adults, and early detection and lifestyle modification will lead to a better health outcome and correlate dietary habits and lifestyle with the prevalence of sarcopenia.

Incidence, prevalence, and treatment of Moyamoya disease in Japan: A population-based descriptive study

BackgroundMoyamoya disease (MMD) is characterized by progressive stenosis or occlusion of the terminal portions of the bilateral internal carotid arteries. A Japanese survey in 2003 reported an incidence and prevalence of MMD of 0.54 and 6.03 per 100,000 people, respectively, showing an upward trend over previous surveys. An update to these estimates is therefore warranted. Additionally, evidence is lacking on trends in revascularization and antiplatelet therapy in MMD patients. MethodsWe conducted a population-based descriptive study using a Japanese claims database. From fiscal year (FY) 2015 to 2019, we standardized the incidence and prevalence estimates of MMD to the 2015 Japanese census population by age and sex. We also estimated the 1-year cumulative incidence of revascularization among incident MMD patients and the proportion of prevalent MMD patients receiving antiplatelet therapy in each FY. ResultsThe age-standardized male-to-female ratio of both incident and prevalent MMD patients was approximately 1:2. Standardized incidence and prevalence of MMD per 100,000 population increased slightly from 1.8 to 2.4 and 14.7 to 17.6, respectively. The 1-year cumulative incidence of revascularization among incident MMD patients varied between 21.9 % and 28.9 %. Among prevalent MMD patients, 36.6 % to 39.0 % received antiplatelet therapy. ConclusionsThe incidence and prevalence of MMD in Japan from FY 2015 to 2019 were higher than those estimated in 2003. The trends in revascularization and antiplatelet therapy identified in this study will be useful in further improving the quality of MMD clinical practice.

Prevalence and Magnitude of Olfactory Dysfunction in Allergic Rhinitis.

Although allergic rhinitis (AR) can negatively impact the ability to smell, the degree to which this occurs is not clear and prevalence estimates vary among studies. This study had 4 main objectives: (1) To estimate the prevalence and the degree of olfactory dysfunction in AR patients; (2) To compare olfactory perception between AR patients with different persistence and severity of symptoms and determine if olfactory testing may aid in differentiating among Allergic Rhinitis and its Impact on Asthma (ARIA) groups; (3) To determine whether allergic reactions to different allergens differentially impact olfactory function, and (4) Verify possible changes in the olfactory epithelium (OE) caused by AR. One hundred thirty-three patients with AR and one hundred controls were tested. The main outcome was the score in University of Pennsylvania Smell Identification Test (UPSIT®). The OE was examined using immunofluorescence markers for neuronal activity, apoptosis, oxidative stress, signal transduction, eosinophils, and epithelial thickness. Prevalence of olfactory dysfunction in the AR patients was higher (AR: 42.9% vs controls: 9%, P < .001). No difference was found either between intermittent and persistent disease cases (P = .58) or between cases with mild and those with moderate/severe symptomatology (P = .33). Lower olfactory capacity was not associated with the reaction to more (P = .48) or diverse types of allergens (Ps > .05). Although not significant, patients with AR had a greater amount of eosinophilia and a lower amount of cAMP (cyclic adenosine monophosphate) in the OE. The study highlights a higher prevalence of olfactory dysfunction in AR patients compared to controls, but olfactory testing may not effectively differentiate AR severity or allergen sensitivities. Although trends suggest potential pathophysiological changes in the OE of AR patients, further research is needed to validate these findings.

HIV estimation using population-based surveys with non-response: A partial identification approach.

HIV estimation using data from the demographic and health surveys (DHS) is limited by the presence of non-response and test refusals. Conventional adjustments such as imputation require the data to be missing at random. Methods that use instrumental variables allow the possibility that prevalence is different between the respondents and non-respondents, but their performance depends critically on the validity of the instrument. Using Manski's partial identification approach, we form instrumental variable bounds for HIV prevalence from a pool of candidate instruments. Our method does not require all candidate instruments to be valid. We use a simulation study to evaluate and compare our method against its competitors. We illustrate the proposed method using DHS data from Zambia, Malawi and Kenya. Our simulations show that imputation leads to seriously biased results even under mild violations of non-random missingness. Using worst case identification bounds that do not make assumptions about the non-response mechanism is robust but not informative. By taking the union of instrumental variable bounds balances informativeness of the bounds and robustness to inclusion of some invalid instruments. Non-response and refusals are ubiquitous in population based HIV data such as those collected under the DHS. Partial identification bounds provide a robust solution to HIV prevalence estimation without strong assumptions. Union bounds are significantly more informative than the worst case bounds without sacrificing credibility.